As has been discussed on this blog many times before, the chiropractic profession seems to be in a bit of a crisis (my attempt at a British understatement). The Australian chiropractor, Bruce Walker, thinks that, with the adoption of his ten point plan, “the chiropractic profession has an opportunity to turn things around within a generation. Importantly, it has an obligation to the public and to successive generations of chiropractors ahead of it. By embracing this plan the profession can be set on a new path, a new beginning and a new direction. This plan should be known as the new chiropractic.”
And now you are. of course, dying to hear this 10 point plan – well, here it is [heavily abbreviated, I am afraid (the footnotes [ ] and the comments referring to them are mine)]:
- There is a need to improve pre professional education for chiropractors.
Universities or private colleges?
Chiropractic education should where possible be conducted at universities [1] and this does not mean small single purpose institutions that are deemed universities in name only. Why is this recommended? Primarily because unlike some private colleges, government funded universities insist on intellectual evidence based rigour [2] in their learning and teaching and importantly require staff to be research active. Chiropractic courses need to have an underpinning pedagogy that insists that content [3] is taught in the context of the evidence [4] and that students obtain the necessary training to question and critically appraise [5]…
Accreditation problems
Underpinning chiropractic education is program accreditation and this is also in need of review particularly where vitalistic subluxation [6] based courses have been legitimised by the accreditation process…
Hospital training
Chiropractic education should also involve specifically relevant hospital access or work experience such as hospital rounds so that students can observe patients that are truly unwell and observe the signs and symptoms taught in their theory classes. Hospital rounds would also allow chiropractic students to interact with other health providers and increase the likelihood of legitimate partnership and respect between health professions [7].
Who should teach chiropractic students?… - There is a need to establish a progressive identity.
Chiropractors need to become solely musculoskeletal practitioners with a special emphasis on spinal pain [8]. If the profession becomes the world’s experts in this area it will command the respect deserved [9]. Importantly it will not be seen as a collective of alternative medicine practitioners with a strange belief system [10]… - The profession should develop a generalised special interest.
…Chiropractic as a profession should also develop a special interest area in the health sciences that can make a worldwide contribution to other related health sciences. This could be either research based or clinically based or indeed both. Some possibilities are: the further development and refinement of evidence based practice [11], improved posture through motor control, musculoskeletal care for the aged and elderly, improving bone density or the very important area of translating research into practice via implementation science. Whatever chosen we need to develop a special interest that sets us apart as experts in a distinctive area [12]. - Marginalisation of the nonsensical elements within the profession.
As professionals chiropractors should not tolerate colleagues or leadership in the profession who demonstrate aberrant ideas. If colleagues transgress the boundaries or professionalism they should be reported to authorities and this should be followed up with action by those authorities [13]… - The profession and individual practitioners should be pro public health.
It is important to speak up openly in favour of evidence-based public health measures and to join public health associations and agencies [14]… For example, chiropractors promoting anti-vaccination views need to be countered [15]… - Support legitimate organised elements of the profession.
Practitioners should support and become involved in chiropractic organisations that are clearly ethical and evidence based [16] and add value to them…
…Regular collective professional advertising of the benefits of chiropractic for back pain, for example, is a worthy undertaking but the advertisements or media offerings must be evidence based [17]. - The profession should strive to improve clinical practice.
Chiropractors contribute to the public health by the aggregated benefit of positive outcomes to health from their clinical practices [18]… Where restrictive practice laws relating to chiropractors prescribing medication exist the profession should seek to overturn them [19]… - The profession should embrace evidence based practice.
EBP is the amalgam of best scientific evidence plus clinical expertise plus patient values and circumstances. So what could be missing from this equation? It is clear that in the opinion of a sizable minority of the profession the elements that are missing are “practitioner ideology” and “practitioner values and circumstances”. These additional self- serving and dangerous notions should not be entertained. The adoption of evidence based practice is critical to the future of chiropractic and yet there is resistance by elements within the profession. Soft resistance occurs with attempts to change the name of “Evidence-based practice” (EBP) to “Evidence-informed practice” (EIP). It is worth noting that currently there are over 13,000 articles listed in PUBMED on EBP but less than 100 listed on EIP. So why are some of our profession so keen to use this alternate and weaker term?
Hard resistance against EBP occurs where it is stated that the best evidence is that based on practice experience and not research. This apparently is known as Practice Based Evidence (PBE) and has a band of followers [20]… - The profession must support research.Research needs to become the number one aspiration of the profession. Research informs both practice and teaching. Without research the profession will not progress. Sadly, the research contribution by the chiropractic profession can only be described as seed like. Figure 1 is a comparison of articles published in the past 45 years by decade using the key words “Physiotherapy” or “Physical Therapy” versus “Chiropractic” (source PUBMED). The Y axis is the number of articles published and the X axis is the decade, the red represents physiotherapy articles, the blue chiropractic. The difference is stark and needs urgent change [21].
If the profession at large ignores research whether in its conduct, administration or its results the profession will wither on the vine [22]… - Individual chiropractors need to show personal leadership to effect change.
Change within the profession will likely only occur if individual chiropractors show personal leadership….
As part of this personal leadership it will be critical to speak out within the profession. Speak out and become a mentor to less experienced colleagues [23]…
Anyone you thinks that with such a strategy “the chiropractic profession has an opportunity to turn things around within a generation” is, in my view, naïve and deluded. The 10 points are not realistic and woefully incomplete. The most embarrassing omission is a clear statement that chiropractors are fully dedicated to making sure that they serve the best interest of their patients by doing more good than harm.
128 Responses to Does chiropractic have a future?
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Mr Walker’s whole thinking is awry.
He places the cart before the horse.
But form should follow function.
He intends ‘chiropractic’ should be taken seriously as a ‘profession’.
“We profess that by manipulating spines and subluxations, we can release ‘innate vital forces’ which will heal all manner of pathological conditions.”
No matter how he dresses his proposals up, Mr Walker’s objective is to justify ‘chiropractic’ as he and colleagues have formed it, not to devise methods of assisting patients.
If he was serious about caring for patients, why has he not joined a regular healthcare profession such as medicine, nursing or physiotherapy.
Do please move on Mr Walker.
Richard Bruce Walker has been moving on/forward since the 1980’s!
https://www.coca.com.au/about/coca-history/
“No matter how he dresses his proposals up, Mr Walker’s objective is to justify ‘chiropractic’ as he and colleagues have formed it, not to devise methods of assisting patients.”
“Are Reforming” not “formed” would be more appropriate! So you think Bruce Walker is not into assisting patients and providing the best and most up to date evidence based care? Your bias is showing! Is is about time the critics stop carpet bombing the profession and start supporting the reform process instead of automatically shooting the messenger!
“A regular healthcare profession,” stated Mr. Rawlins in his baseless rant regarding his uncountenanced negative opinion regarding chiropractic as a health profession. The majority of practicing chiros diagnose and treat neuromusculoskeletal conditions, often in conjunction with PT’s, physiatrists, and pain management specialists. Are there unethical “wing nuts” in the chiro profession? Yes. Are there unethical MD’s? Yes, and their number is growing rapidly relative to their employment by health insurers as consultants to deny medically necessary care recommended by altruistic physicians. You really do need to inform yourself regarding topics on which you post, Mr. Rawlins.
@ Logos-Bios on Tuesday 06 September 2016 at 17:55
“chiropractic as a health profession.”
Is there any justification?
“The majority of practicing chiros diagnose and treat neuromusculoskeletal conditions, often in conjunction with PT’s, physiatrists, and pain management specialists.”
“neuromusculoskeletal conditions”? You mean the poaching from other healthcare professions to broaden their base, ie, income base?
“Are there unethical “wing nuts” in the chiro profession? Yes.”
Are there ethical chiros? Yes, those who have given up witchcraft and studied a real healthcare profession, if they are capable (very few).
“Are there unethical MD’s? Yes, and their number is growing rapidly relative to their employment by health insurers as consultants to deny medically necessary care recommended by altruistic physicians.”
Tu Quoque.
“You really do need to inform yourself regarding topics on which you post, Mr. Rawlins.”
Laughable, you, a chiro witchdoctor, are trying to tell a medical specialist about medicine.
Hilarious response from the Franksterwhich was vacuous of both cogency and substance. It’s unfortunate that Frankster is unable to cognitively digest the pith of my very clear comments about chiropractic; he apparently was so gobsmacked that he thought I was commenting about a “medical specialty” in my post to which he responded. Comprehension obviously is not one of his strengths, sadly. It’s interesting that one(Frankster) who consistently utilizes Tu Quoque in his rants, typically bereft of substantive criticism yet festooned with insultory verbiage, would aver that my statements of fact were less than veridical. The Frankster really needs to elevate his communication skills to a more professional level to be taken seriously.
“Chiropractic is founded on different principles from those of medicine.”
D.D.Palmer
Well done prof. A critical examination of a “plan” to turn chiro from nutbaggery, founded by a thief and conman premised on a stolen idea with ridiculous embellishments, to a “respectable” healthcare profession.
I have my own plan;
1. Abolish all chiro schools of any persuasion.
2. Abolish any legitimacy they have through any regulation or recognition in law.
3. Ban health insurance companies from providing any benefits for chiro treatment.
4. Require them, if still trading as a quack, to contribute 20% of their gross income to a research foundation in chiropractic run by real scientists (end of chiro there).
5. Require them to maintain patient records through a central registry, at their cost, with follow up of victims.
6. Offer a program where they can retrain as physiotherapists, having to meet the same standards for admission as all other prospective students. (Effectively, none will get into physio.)
7. Test them regularly for any signs of views that support subluxations or any other anti-science beliefs.
That should kill chiro.
Nearly forgot; cue Crackpot_Chiro with all of his nonsense about reform this and change that. If any researchers need a case study of cognitive dissonance, C_C would be a walk up start.
Frank Collins said:
Assuming they see eight customers a day, five days a week, 40 weeks a year and charge a modest £50 per appointment, the 3,000 chiros in the UK alone would raise a whopping £48 million each and every year in the UK alone! Just think what they could do with that!
I have an easy-to-use calculator on my blog that helps explore how quacks can raise money for research – all that’s needed is willpower…and a desire to not mislead the public.
@ Al Henness
Wow…your numerical projections are staggering; meaningless, but staggering. Try this on for size: $30 K per bariatric surgery for an outcome of a moratality rate of 4.6% within a year of the procedure. If chiro treatment led to such mortality outcomes(as spuriously used by many on this site) it would have long ago vanished by the demand of organized medicine and the public. Alas, such has not occurred. Instead, we have huge fees by surgeons for procedures with death outcomes which dwarf those claimed of chiropratic by chiropractic’s most ardent haters. How many surgeries would need be performed by a doctor for an annual net of $1 million? I wonder why so few surgeons spend their own money to do research? Answer: many government agencies and medical equipment manufacturers “pay the freight” because they believe they will will generate a good ROI, despite a 4.6% mortality in less than a year.
Logos-Bios said:
Yes, the amount that chiros could raise is staggering, isn’t it? If only they had the will…
But did you spot any errors in my arithmetic?
You might also like to take some time to learn about logical fallacies.
It’s unfortunate that “Big Al” could conjure nothing substantive to counter my post to which he replied. Did he comment at all relative to the basic numbers I proposed relative to bariatric surgeries and the negative outcomes indigenous to them? Of course he didn’t(couldn’t?)! If only Al was able to sustain his thought process long enough to type something of value san insults………….too much to ask of him, it seems.
@Logos-Bios
If you are unwilling or unable to find any error with what I did write about – as opposed to what I didn’t – then please just say so.
Big Al deflects again, apparently unable to crunch the numbers regarding the amount of money bariatric surgeons could personally contribute to research of a procedure with a 4.6% one-year mortality rate. Try harder, Al. Your responses have been quite weak on this topic.
@Logos-Bios
You haven’t looked up anything about logical fallacies yet, have you? Let us all know when you have.
Look, all this reciprocal yah-boo-sucks stuff is well and good. Logos-Bios keeps on quoting a 4.6% mortality rate for bariatric surgery within a year of the procedure. Where the heck does this figure come from? Logos-Bios is one of many irritating posters on this blog who pull numbers out of the air without providing a reference for their source.
I Googled ‘mortality rates bariatric surgery’ and immediately found the UK National Bariatric Surgery Register report for 2014. of 32,073 operations the in hospital mortality rate was 0.07%. The report mentions an earlier report (covering 2001–2008) in which 30-day mortality was 0.11%. By adding ‘USA’ to the googled text I hit the Obesity Reporter statistics for 2015. 30-day mortality was 0.13% (>60,000) patients.
I was unable to find 12-month data, but it’s important to realize that over a 12-month period, a proportion of people will inevitably die. Reliable data require at least a control group of unoperated, obese patients matched for things like diabetes so their death rates can be compared. That way we’ll get an idea of the death rates possibly attributable to the surgery.
Logos-Bios, either put up or shut up. Where does your magic 4.6% figure come from?!
he/she is just rejoicing in a display of stupidity
No need to research “logical fallacies,” Big Al. Your posts often represent fine examples of same and this forum is replete with them.
@Logos-Bios
You do seem to be throwing them around like confetti with absolutely no awareness that you are.
But it’s a nice meta discussion, isn’t it?
You just have to love Edzard’s one-liners, simple-minded as they are. He must be pretending to be Don Rickles.
Cue Frank Collins with the usual Carpet bombing!
You really are incapable of supporting reform!
I will address some interesting points out of politeness!
#4 The Danish chiro’s have been doing this for years! % of every consultation goes into a research fund! Have you bothered to check out the University of Odense! I have also discussed this with the associations about replicating it here.
#5 The government has proposed doing this with the medico’s here and it has been an absolute mess!
#6 The minority of physio’s that follow the evidence are moving in the same direction! They are also frustrated with resistance from the entrenched dinosaurs within their profession! You should check out their forum SomaSimple! I have had many enjoyable discussions with them over the years!
“Well done prof. A critical examination of a “plan” to turn chiro from nutbaggery, founded by a thief and conman premised on a stolen idea with ridiculous embellishments, to a “respectable” healthcare profession.”
You are as mired in the past as the most rabid subluxationists I have had to deal with! The one positive here is that Prof Ernst has never blocked or deleted me unlike the subluxationists who have on a regular basis! They do not like me questioning their beleifs/religion!
#7 Finally agree with you!
@ Crackpot_Chiro on Wednesday 31 August 2016 at 01:09
This question has been asked so often and ignored every time by you; REFORM WHAT?
Chirocraptic is a load of pseudo-scientific crap so the only solution is to get rid of it. You suffer from such a degree of cognitive dissonance, either wallet or psychologically based, you will not see it.
If it has a solid basis, stump up the research that shows it? You won’t because you can’t.
Chiro has as much credibility as homeopathy, and only those on gravy-train or deluded fools refuse to acknowledge that.
@Frank Collins
Over all the time I have been commenting on this site I have never once messed with peoples names/tags!
That is just common courtesy! @Crackpot_Chiro ????? It is customary to return the courtesy! This is another example of your automatically shooting the messenger!
So again out of politeness:
“cognitive dissonance”
Hmmm I have been very consistent in my thoughts, beliefs and attitudes on this site and my views on the subluxation religion and vitalist chiropractors has been made abundantly clear repeatedly! Yet again you ignore and dismiss!
“If it has a solid basis, stump up the research that shows it? You won’t because you can’t.”
Not once have i claimed a “solid base” and I have cited the research repeatedly over the years which is low to moderate which you again have repeatedly ignored and dismissed! This level of evidence is similar or higher to other approaches to chronic musculoskeletal conditions which I have cited previously and again you have ignored! Any evidence/research is an ongoing and constantly changing process yet you seem to want a nicely packaged finished product! I have also pointed you repeatedly in the direction of researchers, reformers, reform institutions and reforms (again ignored or dismissed) yet you blindly think that all chiropractors have not moved past 1910 and we all practice based upon outdated religious beliefs! You are as entrenched in your own beliefs as the worst subluxationists that I have had to deal with!
“Chiro has as much credibility as homeopathy, and only those on gravy-train or deluded fools refuse to acknowledge that.”
Until the profession deals with the subluxationists I would have to agree with you! The fringe nut jobs will drag the whole profession down! The vitalists should follow Reggie Gold who at least had the integrity to admit that chiropractic had moved on from his outdated beliefs and set up spinology! The subluxationists will not change and the more chiropractors and critics question and hold them to account the more entrenched they become. Maintaining high education standards, inoculating students with critical thinking skills, enforcing registration and ongoing education standards and waiting for the dinosaurs to die out while limiting their influence is the long term goal! The behavior of the vitalist colleges clumping together in the Rubicon Group shows that they are a threatened species!
Chiropractic has and is moving on. The critics need to do the same and as I have said many, many times its time they adopt a two step response to chiropractic.
Step 1. Point out the pseudo-scientific BS which is important for reform and you are already doing!
Step 2. Support reform and the reformers within the profession!
If you are incapable of taking the next step and ignore the reform process then your criticism is just carpet bombing!
Are you capable of supporting reformers like Bruce Walker Frank?
@ Crackpotl_Chiro on Saturday 03 September 2016 at 00:21
“@Frank Collins
Over all the time I have been commenting on this site I have never once messed with peoples names/tags!”
It isn’t the first time I have used this name for you so your indignation now is hard to fathom.
“That is just common courtesy! @Crackpot_Chiro ????? It is customary to return the courtesy! This is another example of your automatically shooting the messenger!”
The messenger of what? All you do is regurgitate the same tired old cliches, heard more times than could be regarded as a “courtesy” and all equally drivel.
““cognitive dissonance”
Hmmm I have been very consistent in my thoughts, beliefs and attitudes on this site and my views on the subluxation religion and vitalist chiropractors has been made abundantly clear repeatedly! Yet again you ignore and dismiss!”
It is equally clear you have no idea what the term means, other than your dissonant take on it. It is not whether your views are inconsistent within themselves, but whether you can accept new information inconsistent with your belief system. This demonstrates your cognitive dissonance as strongly, if not more so, than all of your other supposed refutations.
“Not once have i claimed a “solid base” and I have cited the research repeatedly over the years which is low to moderate which you again have repeatedly ignored and dismissed! This level of evidence is similar or higher to other approaches to chronic musculoskeletal conditions which I have cited previously and again you have ignored! Any evidence/research is an ongoing and constantly changing process yet you seem to want a nicely packaged finished product! I have also pointed you repeatedly in the direction of researchers, reformers, reform institutions and reforms (again ignored or dismissed) yet you blindly think that all chiropractors have not moved past 1910 and we all practice based upon outdated religious beliefs! You are as entrenched in your own beliefs as the worst subluxationists that I have had to deal with!”
As Richard Rawlins said above; get a real qualification in a medical science. You continued attempts at trying to justify chiropractic as anything useful to humanity, apart from your wallet are laughable. I would be too embarrassed to try it but you are above (or, accurately, below any such niceties as decency and dignity) able to recognise this.
“Until the profession deals with the subluxationists I would have to agree with you! The fringe nut jobs will drag the whole profession down! The vitalists should follow Reggie Gold who at least had the integrity to admit that chiropractic had moved on from his outdated beliefs and set up spinology! The subluxationists will not change and the more chiropractors and critics question and hold them to account the more entrenched they become. Maintaining high education standards, inoculating students with critical thinking skills, enforcing registration and ongoing education standards and waiting for the dinosaurs to die out while limiting their influence is the long term goal! The behavior of the vitalist colleges clumping together in the Rubicon Group shows that they are a threatened species!”
I will say it so perhaps you might read the words; CHIROPRACTIC IS TOTAL BULLSHIT, DEVOID OF EVIDENCE AND SUBSTANCE. Using Tu Quoque, as you do often, does not diminish its lack of evidence. You are a charlatan, no different to the subluxationists; you have as much evidence as them, NONE. Your word-salads are amusing in their contortions in trying to make meaningful from the meaningless.
“Chiropractic has and is moving on. The critics need to do the same and as I have said many, many times its time they adopt a two step response to chiropractic.
Step 1. Point out the pseudo-scientific BS which is important for reform and you are already doing!
Step 2. Support reform and the reformers within the profession!
If you are incapable of taking the next step and ignore the reform process then your criticism is just carpet bombing!”
You left out the most important part, something which the prof has been saying for years; there is no evidence to support chirocraptic as a healthcare profession.
“Are you capable of supporting reformers like Bruce Walker Frank?”
Are you serious? I watched the video. It is self-serving bullshit. If you believe it offers anything, apart from portraying chiro as pseudo-scientific nonsense unable to define its basic premise, you are even more deluded than first thought.
Critical_Chiro,
I had always been mystified by your plethora of comments on this website, until your recent replies to the salient points addressed to you by Frank Collins.
I am deeply ashamed to reveal that one of the several branches of alt-med in which I had acquired a high level of proficiency was applied kinesiology[1][2]. When I became aware of what was wrong with it, I had to choose between: trying to reform it; abandoning it; or using it for the purpose of clearly demonstrating to the general public the abject quackery of the alt-med empire. I chose the latter option, and applied kinesiology quickly became by far the most popular component of my Pink Unicorn Therapy (which I designed specifically for the sole purpose of teaching critical thinking skills to the gullible and the vulnerable members of the public).
Let me make the following abundantly clear to you, Critical_Chiro, and to the readers:
There is no such thing as an applied kinesiologist who is a reformed applied kinesiologist;
There is no such thing as a homeopath who is a reformed homeopath;
There is no such thing as a chiropractor who is a reformed chiropractor;
There is no such thing as a snake oil vendor who is a reformed snake oil vendor.
Professor Ernst is a shining example of the hardships that we are all duty-bound to undertake when our deeply-held beliefs, our profession, and/or our experience, has been independently verified to be false.
[1] https://en.wikipedia.org/wiki/Applied_kinesiology
[2] http://edzardernst.com/category/kinesiology/
Pete Attkins must surely have been lacking in perspicacity if he wasted even a minute of his time “learning” Applied Kinesiology. Only pseudo-scientific dupes would commit to spending any time whatsoever in becoming “proficient” in the non-chiropractic discipline. Now here’s Pete trying to pay penance for his sins of misleading his patients and the public at large regarding a practice of buffoonery(AK) in a clinical setting. One must wonder why anyone on this site would value opinions lobbed into this forum from someone so gullible. No such thing as a reformed AK’er? In your case I must agree.
@ Logos-Bios on Tuesday 06 September 2016 at 21:24
“Pete Attkins must surely have been lacking in perspicacity if he wasted even a minute of his time “learning” Applied Kinesiology. Only pseudo-scientific dupes would commit to spending any time whatsoever in becoming “proficient” in the non-chiropractic discipline.”
Applied Kinesiology isn’t a chiropractic discipline? Not according to the many who advertise it.
“Now here’s Pete trying to pay penance for his sins of misleading his patients and the public at large regarding a practice of buffoonery(AK) in a clinical setting. One must wonder why anyone on this site would value opinions lobbed into this forum from someone so gullible. No such thing as a reformed AK’er? In your case I must agree.”
At least Pete had the integrity and honesty to admit his mistake, unlike your colleagues who continue to practice the nonsense.
As to valued opinions; why would anyone value the views of someone who engages in a practice that has virtually no evidence of efficacy? That would be you, non-doctor, non-physician.
I have a question for Frank Collins.
Are you in the field of Psychology?
@Tim Manchin on Thursday 08 February 2018 at 21:37
“I have a question for Frank Collins.
Are you in the field of Psychology?”
No, Timmy, I’m not, but you are in the field of chiro-nonsense and ‘treat'(stifles a laugh) these conditions:
Arthritis
Back Disorders
Back Injuries
Back Sprain
Carpal Tunnel Syndrome
Head and Neck Conditions
Headache
Herniated Disc
Lower Back Injuries
Migraine
Neck Injuries
Neck Muscle Strain
Neck Pain
Sciatica (Not Due to Disc Displacement)
Scoliosis
Shoulder Pain
Sports Injuries
Whiplash
using the ‘techniques’;
Active Release Technique
Chronic Pain Management
Cold Laser Therapy
Electrical Stimulation
Exercise Counseling
Kinesio® Taping
Low Back Procedure
Manipulation Adjustment of Back and Neck
Neck Pain Procedure
Pain Management
Physical Examination
Physical Therapy
Spinal Decompression
Spine and Back Procedures
Therapeutic Massage
Trigger Point Therapy
Ultrasound
Wellness Examination
@ Frank Collins
One must simply laugh at the extremes to which anti-chiro folks will go in attempting to spin every negative perception regarding the profession as emblematic of the profession at large. We have medical subspecialties such as bariatric surgery in which even the most friendly researchers purport .2-.5% deaths within a month of surgery. Some studies have uncovered that 4.6% of post-surgical patients die within a year. Of course such reporting doesn’t even take into account the attributing by bariatric-surgery stakeholders of post-surgical deaths to “other” causes; were the “logic” of contrived cause and effect applied to bariatric surgery in the way some here are applying it to chiropractic cervical manipulation, it would be clear to even the uninformed that such surgeries should be considered at least as dubious from a mortality standpoint. I wonder why malpractice insurance for chiropractic physicians is but a fraction of that paid by bariatric surgeons if, in fact, chiropractic care is so dangerous? Of course, these surgeons enjoy tens of thousands of dollars to perform their craft…they can afford it.
you can stop wondering:
surgeons operate on people suffering from serious diseases.
chiropractors tend to treat people with back pain or other relatively minor symptons.
see the difference?
Sorry Edzard, your missive was self-serving and tangential to my comments. I’m not surprised. BTW, I hope you know that LBP is the world’s leading “disabler.” It’s alarming that you would disrespect the suffering of so many people merely to support your hate of chiropractic physicians. I think you should educate yourself regarding the goal of any type of physical rehabilitaion, whether performed by a chiro physician, PT, or both. The goal is not simply relief of symptoms; rather, goals involve progressive increase in function. I’m not referring only to the various ADL assessments, but also to demonstrably improved joint function, proprioception, and muscular coordination during movements. Certainly some on this site are happy to believe if Ibuprofen relieves pain consistently over a course of months, the patient should “keep on keepin’ on.” Get it now?
@ Logos-Bios on Tuesday 06 September 2016 at 17:42
Well johnny-come-lately, this has been mentioned (many times) before and the prof has responded.
It is as laughable as usual. It is obvious you are a chiro by the use of the specious term, “chiropractic physicians”, and equally obvious you have a great deal of self-affection, evidenced by your ignorance and pomposity. (It never ceases to amuse me how chiros have such a high opinion of themselves and their witchcraft, yet can’t write coherently with proper grammar.)
Chiros faff around with backs and use funny gadgets like the Activator and the clunky table to treat self-limiting conditions, while doctors cut people open and re-arrange the patients’ organs, yet you claim some equivalency? Have alook in the mirror and ask yourself whether you are qualified to lance a boil?
I know this won’t make a difference to you and you will just go back to pilfering people’s money fraudulently with hocus-pocus nonsense. Then again, I have a clear conscience while you don’t have one.
@Logos-Bios
Would be better to know what you are talking about.
Mortality in my part of the world is 0,040 %*
Mean excess BMI loss from Gastric bypass is about 80% in the first couple years and the outcome of the surgery improves or resolves more than 40 conditions related to obesity, reduces mortality from cancer by 60%, coronary artery disease by 56% and type 2 diabetes by 92%
Now tell us what chiropractic adjusting of “subluxations” (which no one has been able to find by the way) can do for morbid obesity?
* (The referenced report from “SOReg”, the Scandinavian Obesity Surgery Registry is in Swedish. It is based on follow up of about 14000 cases for one year and 6000 for two years. My service has operated about one thousand per year in the period reported.)
@ Edzard
If low back pain is a relatively minor symptom, why does it cause more global disability than any other condition?
minor symptoms can be prevalent
@ Edzard
It is not the prevalence that is the issue. A minor symptom (as you view it) shouldn’t cause as much disability.
I would say that your view of low back pain (as a minor symptom) goes against most epidemiological evidence.
yes, you would – but you would be wrong.
@ Edzard
How am I wrong? Evidence please!
Dr. Geir asked to what I was referring in my post regarding mortality risk/complications with bariatric surgeries. Note that he didn’t address my statistics regarding same. They were clearly stated and could’ve easily been accessed via pubMed, Nexis, or even Google. Instead he proffered some positive outcomes relative to the procedures in “his part of the world.” It would seem as though Geir would have us believe that surgeons there(wherever there is) are more skilled or meticulous than those in the US so as to not be bedeviled with those nasty negative outcomes; yeah, right! More likely many of the negative outcomes are ascribed to “other causes” and some simply haven’t been accounted for assiduously; such would yield results which would make the procedures appear less dangerous. Of course Geir quickly steered the conversation a different direction with his non sequitur regarding “subluxations.” I don’t understand why so many on this site, and Geir in particular, have such abysmally short attention spans. Note to all: the post to which Geir responded didn’t reference subluxations. Please stay on topic to give at least the appearance of credibility.
Pathetic conjecture, misquoting, non-sequitur and ignorance of the subject.
It is quite interesting how apologists of make-believe medicine can subliminally cherry pick information from what they read, even from short and concise texts.
I referenced not just “some positive outcomes” but an independent national database known for its methodological rigour and quality. Controllers from this audit system regularly go into the surgical centres and check the data.
The information about where these data come from seems to have been bypassed or suppressed by L-B’s cognitive impairment. Sweden is well known for its socialised medical system and nit-pickingly thourough quality checking and safety monitoring of medical services. If figures from there cannot be trusted, nothing can.
L-B pulls herself (himself?) up in an indignant rant about me going off topic despite having actually introduced this completely off-topic, lame attempt at tu-quoque argumentation i.e. the matter of poor results in some bariatric surgical services.
I merely pointed out that the cherry-picked numbers L-B quoted did not represent the modern state of the art in a global perspective.
I also asked (right on the topic of whether there was any future for chiropractic) whether chiropractic, the art of adjusting subluxations, had anything similarly efficient and beneficial to offer the patient population L-B himself/herself brought into the discussion.
“Pathetic conjecture, misquoting, non sequitur, and ignorance of the subject,” stated Geir. I agree that virtually every comment he posts regarding chiropractic would be accurately described by these descriptors; his comments reek of abject ignorance and bias. However, this response by Geir, the pseudo-intellectual(note to Geir: intellectuals comment about subjects in which they are knowledgeable), served only to demonstrate his protectionist proclivities regarding his sub-specialty and the negative bariatric surgery outcomes which have been statistically reported.
Geir implied that patients die less often resultant to bariatric surgery procedures in “his part of the world.” Are Swedish surgeons more skilled or are their patients more hardy? Do deaths from CAD, HT, or suicide even get considered as related to the procedures? Perhaps Geir is merely embarrassed that such surgeries, even when performed ideally, yield a death outcome 4.6% of the time; thus his use(overuse) of tu quoque in his own writings even as he blathers on about subluxations in this entirely separate topic. One must wonder if Geir even understands that his claims of tu quoque are swathed with hypocrisy given the lackluster substance of his rants.
Geir fancies himself knowledgeable about chiropractic subluxations. Perhaps he might enlighten me because I have no experience treating them, diagnosing them, or even discussing the term very often. Given his ignorant proclivity towards injecting them into conversations, I’d be interested in knowing why he believes they are relevant to a discussion regarding the much higher mortality risk of largely elective (and advertised for) weight-loss procedures versus conservative diagnosis/management of neuromusculoskeletal disorders by chiropractic physicians. I hope he actually addresses my questions directly. His obfuscations, while amusing in an odd sort of way, evince that he is more of a info-challenged cynic about chiropractice than he is a truth-teller regarding bariatric surgery’s negative outcomes.
I think you are beyond being ‘enlightened’
@ Edzard
You have yet to present any evidence or explain how I am wrong? Will you answer my question?
For the second time, Logos-Bios, where do you get your mortality data from? Who are these ‘even the most friendly researchers’ who purport .2–.5% deaths within a month of bariatric surgery. Which are the studies (plural) that have uncovered that 4.6% of patients die within a year and how were they controlled for death rates among a comparable population?
I suspect that most readers of this blog are put off by your aggressive but insubstantive responses to comments. Please will you, very simply, state the sources of your data. Without them you are farting into the wind.
Bios-Logos on the subject of chiropractic subluxations:
Not even a proper chiropractor. How queer 😀
@ Edzard
I will take the lack of a reply and evidence, as I am right and you are wrong.
@ AN Other on Friday 09 September 2016 at 16:56
“@ Edzard
I will take the lack of a reply and evidence, as I am right and you are wrong.”
I wouldn’t; the prof may not think it worthwhile answering, I don’t.
Are you still trying to justify your employment as a receptionist in an alt-med clinic?
@ Frank
What question by me do you think Prof Ernst shouldn’t be answeing?
Also if Edzard doesn’t show me how I was wrong, he is no better than some other posters on here, who say they are right but don’t produce evidence to prove so.
p.s. keep on guessing about my occupation – you are still wrong about what I do and why it is necessary for you to know!
@ AN Other on Saturday 10 September 2016 at 10:34
“What question by me do you think Prof Ernst shouldn’t be answeing?
Also if Edzard doesn’t show me how I was wrong, he is no better than some other posters on here, who say they are right but don’t produce evidence to prove so.”
So you post an assertion, reverse the onus of proof, then demand the prof prove the negative without providing evidence yourself. Nice work of hypocrisy there.
“p.s. keep on guessing about my occupation – you are still wrong about what I do and why it is necessary for you to know!”
Because, dear receptionist, you have skin in the game somewhere; otherwise you wouldn’t be doing what you do. Why not say what your involvement is? Unless you are ashamed, which is my guess?
@Frank
Prof Ernst made the assertion that low back pain is a minor symptom. There is plenty of evidence to prove this assertion is wrong especially as a cause of disability – ( see the global burden of low back pain in the annals of rheumatic diseases). I am sure Prof Ernst should be aware of this study and other evidence considering he has written articles about the treatment of low back pain.
Prof Ernst said I was wrong, I asked him how. He hasn’t replied. I still feel that he should prove that I am wrong rather than I accept his original assertion that low back pain is a minor symptom (which he didn’t provide any evidence for).
Also, I would have thought that as someone who had an episode of low back and leg pain that ended with surgery, you would find the assertion that low back pain is a minor symptom incorrect.
Finally, again you don’t explain why it is so important for you to know my occupation and you make another incorrect guess about me. Other posters on here such as Blue Wode remain anonymous – you accept their right to do so. I think that is a good example of hypocrisy.
@ AN Other on Sunday 11 September 2016 at 08:19
Well, dear receptionist, we know some things about you; you live on the east coast of Australia, you have a faulty memory, you draw wrong inferences, you are fond of Logical Fallacies (Tu Quoque, in particular) you work in alt-med, you have difficulty processing text, you try to justify and rationalise your livelihood, and some others with which I will deal at the end.
“Prof Ernst made the assertion that low back pain is a minor symptom. There is plenty of evidence to prove this assertion is wrong especially as a cause of disability – ( see the global burden of low back pain in the annals of rheumatic diseases). I am sure Prof Ernst should be aware of this study and other evidence considering he has written articles about the treatment of low back pain.”
See the first paragraph.
“Prof Ernst said I was wrong, I asked him how. He hasn’t replied. I still feel that he should prove that I am wrong rather than I accept his original assertion that low back pain is a minor symptom (which he didn’t provide any evidence for).”
See the first paragraph.
“Also, I would have thought that as someone who had an episode of low back and leg pain that ended with surgery, you would find the assertion that low back pain is a minor symptom incorrect.”
I didn’t have “low back pain”, I had moderate sciatica down my right leg for over nine months during which I had a noticeable limp, when chiro exacerbated it and I was totally incapacitated with extreme sciatic pain for six weeks, during which I could not even stand and, often, was reduced to rears through continuous and extraordinary pain. I repeat; I DID NOT HAVE LOW BACK PAIN. I had two ruptures at L5/S1 which is a spinal injury
“Finally, again you don’t explain why it is so important for you to know my occupation and you make another incorrect guess about me. Other posters on here such as Blue Wode remain anonymous – you accept their right to do so. I think that is a good example of hypocrisy.”
Blue Wode is contactable and will respond if contacted. His/her views are clear and unambiguous, and s/he doesn’t write stupid posts (strong inference here).
I repeat;
“Because, dear receptionist, you have skin in the game somewhere; otherwise you wouldn’t be doing what you do. Why not say what your involvement is? Unless you are ashamed, which is my guess?”
I also quote the prof;
“Edzard on Tuesday 06 September 2016 at 17:48
you can stop wondering:
surgeons operate on people suffering from serious diseases.
chiropractors tend to treat people with back pain or other relatively minor symptoms.
see the difference?”
I may have referred to you once as “dopey”; you do your best to ratify that assertion.
@ Frank
Would you say that Prof Ernst was thinking that back pain is a minor symptom when he said “back problems are one of the most common illnesses that plague us”?
@ AN Other on Monday 12 September 2016 at 09:52
“Would you say that Prof Ernst was thinking that back pain is a minor symptom when he said “back problems are one of the most common illnesses that plague us”?”
Dear Annie, you are conflating separate issues; nothing new for you. See if you can work it out?
@ Frank
See you are avoiding the question – nothing new for you there!
@ AN Other on Tuesday 13 September 2016 at 08:45
Dear Annie (receptionist),
I answered your question. The problem resides with your incapacity to deduce even the simplest of questions.
This is the post;
************************************************************
“Would you say that Prof Ernst was thinking that back pain is a minor symptom when he said “back problems are one of the most common illnesses that plague us”?”
Dear Annie, you are conflating separate issues; nothing new for you. See if you can work it out?
***********************************************************
It is tiresome having to explain such simple things, but if I must. There is no question back pain is common and is “one of the most common illnesses that plague us”. That, however, does not make it other than a minor symptom from which many suffer. It is subject to all of the nuances of such a general term for many variants. For the most part, people recover reasonably quickly. Latest research suggests sufferers should go about the normal activities as much as possible and exercise to gain muscle strength and tone in the abdomen. Just for you; https://en.wikipedia.org/wiki/Abdomen
It is also extraordinary how you are able to ignore large chunks of my responses when it does not suit your needs. You didn’t mention your error about my back, for instance.
“See you are avoiding the question – nothing new for you there!”
You are a tedious receptionist. Is Tu Quoque the uppermost limit of your intelligence. (Rhetorical question alert.)
Now that question again; what skin do you have in the game?
@ Frank
If you read earlier posts in this thread I had said that it wasn’t about the prevalence of low back pain (how common it is), but the high level of disability that makes low back pain more than a minor symptom. Even Prof Ernst recognises that low back pain is amongst the leading causes of disability (in fact it is the leading cause of disability). Prof Ernst clarified (in one his more recent posts on this blog) that “Low back pain (LBP) is a ‘minor complaint’ in the sense that it does not cost patients’ lives”. I would say that is a pretty high threshold for defining what is a minor complaint/symptom. Under that definition a cluster headache would be a minor complaint, which most, if not all, sufferers would say that it is definitely not a minor complaint.
My point regarding the quotation of Prof Ernst statement “back problems are one of the most common illnesses that plague us” was that the language used was particularly strong for someone who views it as a minor symptom. If I wrote that the common cold is one of the most common illnesses that plague us, I would think that people would feel that I was over stating the issue.
In fact there is a lack of consensus regarding prognosis (recovery time) for people with low back pain. The 90% of patients recovering within 6 weeks might be too optimistic. A study by Nicholas Henschke et al (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483884/) discusses the methodological shortcoming of previous studies, which lead to the above figure of 90% (please read the study). The study concluded “recovery from recent onset low back pain was much slower than has been reported and nearly a third did not recover within a year”
Actually the latest advice from experts regarding about “exercise to gain muscle strength and tone in the abdomen” is obviously not what you think – http://www.theaustralian.com.au/news/latest-news/dismantling-the-core-to-better-back-care/news-story/1b987b4d304df61546bb6bf35229c228
Regarding your episode of right leg pain as a consequence of a L5/S1 disc injury.
In a past discussion with you (the one where you forgot you had a CT scan and thought you had a MRI, even though a MRI machine was not in Australia at the time), I made a comment about you having low back pain as well as right leg pain. However, at that time you did not correct me. So I just assumed you had low back pain as well as your right leg pain.
In addition, a L5/S1 disc injury is an example of a low back pain complaint, so even though you had just right leg pain, you were suffering from a low back pain complaint. When low back pain is defined for an epidemiological study it is described as “pain in the area on the posterior aspect of the body from the lower margin of the twelfth ribs to the lower gluteal folds with or without pain referred into one or both lower limbs that lasts for at least one day.” – http://ard.bmj.com/content/early/2014/02/14/annrheumdis-2013-204428
On you acceptance of Blue Wode’s anonymity just because Blue Wode is contactable and will respond if contacted. How is this affecting Blue Wode’s anonymity? If I contacted Blue Wode via Blue Wode’s website and there was a reply, I would still not know who Blue Wode was, or Blue Wode’s occupation or where Blue Wode lives. So, I ask again why do you accept Blue Wode’s anonymity and not mine? Why do you need to know “what skin do I have in the game”?
Finally, you have no clue who I am, where I am or anything else about me – keep on guessing, even a blind pig can find an acorn.
p.s. I did not have access to my computer for the last few days, so the past short reply was from my phone. Just to answer why i missed out answering some other details.
@ AN Other on Friday 16 September 2016 at 19:17
Dear Annie,
I am starting to wonder whether you are two (or more) people; sometimes you are lucid, other times not.
“the one where you forgot you had a CT scan and thought you had a MRI, even though a MRI machine was not in Australia at the time”
Yep, 30 years will diminish a memory for a man………………………… Yet, you can remember everything so it seems, except what doesn’t suit.
“Why do you need to know “what skin do I have in the game”?”
Because you do and it would explain why you make the observations you do. You have a very specific interest and I believe you should divulge that interest.
“Finally, you have no clue who I am, where I am or anything else about me – keep on guessing, even a blind pig can find an acorn.”
I know several things about you; you are a woman, are a PITA, have skin in the game, have an agenda, and are a coward.
Who knows though, an acorn might be able to find a blind pig?
@ Frank
Your memory for your low back problem seems to be very precise regarding the operation and the exact disc that was affected. But for the scan used – not so good, seems to me you are just as selective as your view of my memory.
“It is extraordinary how you are able to ignore large chunks of my responses when it does not suit your needs” – are you going to take your own advice? Did you even read the studies I referred to? Are you going to change your mind when the facts change?
If Blue Wode comes out and explains the skin Blue Wode has in the game, then I will too. Also if you know so much about me, prove it with evidence. However, considering you history of using and understanding evidence, I don’t hold much hope.
Frank Collins on Saturday 10 February 2018 at 01:20
@AN Other on Sunday 18 September 2016 at 12:22
Hello Annie (receptionist),
I missed this but will reply now.
“Your memory for your low back problem seems to be very precise regarding the operation and the exact disc that was affected. But for the scan used – not so good, seems to me you are just as selective as your view of my memory.”
As a receptionist in a chiro/alt-non-med place, you may have seen people in pain. Perhaps you are aware of the debilitating affects of extreme, unremmitting pain, though I doubt it. This may come as a surprise but I had the scan when I had had searing pain for four weeks. That might explain (to a rational person) the haziness of the memory of it. As for the location of the disc, I still have a very visible and tactile reminder over L5/S1, as well as the medical report and a little plastic jar that contains the bit of me removed during the operation. Now, that isn’t so hard, is it?
“Are you going to change your mind when the facts change?”
Yes, when the facts change. When there is real evidence, not the crap you post.
“If Blue Wode comes out and explains the skin Blue Wode has in the game, then I will too. Also if you know so much about me, prove it with evidence. However, considering you history of using and understanding evidence, I don’t hold much hope.”
Using Tu Quoque (again) isn’t an argument. You are a coward. As for the rest, more Tu Quoque from a too cock, pfffft.
It appears that the Frankster has a padawan(Pete); or is it the other way round? It’s amusing to see Frankster’s sticking up for a fellow who actually practiced AK to the point where he was “highly trained” in it. At least Frank had one thing right in principle: it would be unwise to accept the opinion of a highly trained AK’er, especially since said AK’er has admitted that, to paraphrase, there is no such thing as a reformed AK’er. Note that Frankster forgets(did he ever know?) that chiropractic physicians diagnose?
Thus far in 2016 I have diagnosed two cases of MS, two breast masses, one of which ultimately was confirmed at biopsy as breast CA, multiple UTI’s masquerading as back pain, two cases of BPH, and the list could continue. In each case the patient was referred to the proper medical specialist without my having administered any chirpopractic treatment which, of course, would not have been medically necessary to mange the disorders. Good ol’ Frankster obviously is unable to get his head out of the sand and realize that chiropractic as taught by accredited institutions includes diagnosis; this is what distinguishes ethical chiros from PT’s and other paramedical alternative-therapy providers. Frankster seems to delight in commenting on subjects about which he knows little…or nothing. At least his rants are amusing in a kindergarten sort of way; not so much in a profession blog, though.
I guess if chiropractors make a habit of fondling their customer’s breasts pretending to be doctors who know what they are doing, they will inevitably encounter a mass or two per year. Breast masses are common but most are benign.
I wonder how laws are in that particular quack’s country regarding masquerading as a doctor and in particular inappropriate examinations of women’s finer parts under the pretense of healthcare? I wonder if he is also one of those chiroquacks who stick fingers into women’s anus pretending to adjust the coccyx.
As expected, Geir resorts to vile insults when confronted with his own profession’s mortality outcome rates as compared to the relative safety of CMT. His ignorance again rears its ugly(literally) head in implying that chiropractic doctors are not educated in breast examinations(board exams require proficiency in same). Perhaps he regrets his decision to subspecialize, no longer being able to “examine” breast tissue sans a populated OR stage. At least a populated OR likely tamps down his apparent(based on his taking this conversation into the gutter) carnal proclivities. His comments are PRICELESS! Deranged, tacky….but PRICELESS.
If possible, Geir, please try to keep your comments cogent and informed. You’ll appear less dimwitted.
Hi Frank Odds. JAMA vol 294; Issue 15; 10/19/05 represents but one reference of bariatric surgery’s LT mortality rate.
@ Logos-Bios on Thursday 08 September 2016 at 20:42
“As expected, Geir resorts to vile insults when confronted with his own profession’s mortality outcome rates as compared to the relative safety of CMT.”
Hmmmm;
“Logos-Bios on Saturday 10 September 2016 at 01:25
Of course most of the pseudo-intellectuals on this site appear to self-gratify by criticizing chiro via typing with one hand and doing who knows what with the other(perhaps actually researching the subject? Of course not!).”
@Logos-Bios on Saturday 10 September 2016 at 00:58
”
Hi Frank Odds. JAMA vol 294; Issue 15; 10/19/05 represents but one reference of bariatric surgery’s LT mortality rate.”
From said article (inter alia);
***************************************************************************
Millions of individuals in the United States and around the world are overweight or obese (severely overweight). When weight increases to an extreme level, it is called morbid obesity. Obesity is associated with diabetes, heart disease, high blood pressure, some types of cancer, and other medical problems. Bariatrics is the field of medicine that specializes in treating obesity. Bariatric surgery is the term for operations to help promote weight loss. Bariatric surgical procedures are only considered for people with severe obesity and not for individuals with a mild weight problem. The October 19, 2005, issue of JAMA includes several articles about bariatric surgical procedures for the treatment of obesity.
Bariatric surgery may be offered to patients with severe obesity when medical treatments, including lifestyle changes of healthful eating and regular exercise, have not been effective.
CONSIDERATIONS FOR BARIATRIC SURGERY
Individuals considering bariatric surgery must discuss risks and possible benefits with their doctor. Bariatric surgery has associated risks and long-term consequences and should be considered only one part of an approach to treating obesity. Most bariatric surgeons think that the operations work best when they help promote lifelong behavioral and dietary changes. Long-term follow-up with doctors experienced in the care of patients having these procedures, as well as lifelong vitamin supplementation, is essential to avoid life-threatening complications.
**************************************************************************
This should be self-explanatory (but I won’t bank on it).
And this is Walker blabbing on about it;
https://www.youtube.com/watch?v=zbb23xxp2JM&feature=youtu.be
It doesn’t make any more sense delivered verbally.
Well, thank you, Frank, for actually reading the citation I mentioned. Why didn’t you comment about the 4.6% 1-year mortality rate associated with the surgeries? Nowhere have I averred that bariatric surgeries are valueless; rather, I noted that the 1-yr. mortality rate associated with them was significantly higher than that for cervical CMT. Of course the 4.6% might be conservative depending upon how “ancillary” causes of post-bariatric surgical deaths are reported.
It’s interesting that you cut and pasted indications for the surgery and yes, the information was self-explanatory. Such indications could also be listed for proper medications, CA treatments, PT, chiro, and orthopedic interventions. However, we were discussing the probability of deleterious consequences of bariatric surgeries vs. cervical CMT, if you’ll kindly recall.
Again, thank you for referencing my citation. For what it’s worth, you earned some respect with your perceived earnestness.
@ Logos-Bios on Sunday 11 September 2016 at 23:32
“Why didn’t you comment about the 4.6% 1-year mortality rate associated with the surgeries?”
I did.
“However, we were discussing the probability of deleterious consequences of bariatric surgeries vs. cervical CMT, if you’ll kindly recall.”
Yes, that is why I quoted those sections; my intention is clear. (I know I will have to explain this, sooner or later, so; one is a risky procedure based on life threatening obesity, while the other is a potentially life-threatening procedure for which the risk-benefit analysis is negative.)
Frank, Pardon me, but I see no mention in your post of the 4.6% number or a comparison to significant negative outcomes from CMT.
“One is a risky procedure based on life threatening obesity, while the other is a potentially life-threatening procedure for which the risk-benefit analysis is negative.), ” stated Frank. I must say I do appreciate the humor in your statement; you are on your game today. Please kindly point to me citations which demonstrate that obesity is more significant a disabler than LB pain. Also, your thoughts on the many ads and apps proffered by unscrupulous bariatric surgeons to attract new, generally healthy, patients who have dreams of looking like Beyonce would be welcome. I wonder if the 4.6% one-year mortality rate would be considered acceptable to you for such carnival-barkers.
@ Logos-Bios on Monday 12 September 2016 at 23:58
“Frank, Pardon me, but I see no mention in your post of the 4.6% number or a comparison to significant negative outcomes from CMT.”
The quotes from your link answered the question.
“Please kindly point to me citations which demonstrate that obesity is more significant a disabler than LB pain.”
I didn’t write that. Read it again.
“Also, your thoughts on the many ads and apps proffered by unscrupulous bariatric surgeons to attract new, generally healthy, patients who have dreams of looking like Beyonce would be welcome.”
I live in a civilised country and am not familiar with the practices of the US. Having said that, I despise all unscrupulous behaviour.
“I wonder if the 4.6% one-year mortality rate would be considered acceptable to you for such carnival-barkers.”
The mortality rate is over 11 years old and I am confident there have been improvements since then. I will, nonetheless, quote again;
***************************************************************************
Millions of individuals in the United States and around the world are overweight or obese (severely overweight). When weight increases to an extreme level, it is called morbid obesity. Obesity is associated with diabetes, heart disease, high blood pressure, some types of cancer, and other medical problems. Bariatrics is the field of medicine that specializes in treating obesity. Bariatric surgery is the term for operations to help promote weight loss. Bariatric surgical procedures are only considered for people with severe obesity and not for individuals with a mild weight problem. The October 19, 2005, issue of JAMA includes several articles about bariatric surgical procedures for the treatment of obesity.
Bariatric surgery may be offered to patients with severe obesity when medical treatments, including lifestyle changes of healthful eating and regular exercise, have not been effective.
CONSIDERATIONS FOR BARIATRIC SURGERY
Individuals considering bariatric surgery must discuss risks and possible benefits with their doctor. Bariatric surgery has associated risks and long-term consequences and should be considered only one part of an approach to treating obesity. Most bariatric surgeons think that the operations work best when they help promote lifelong behavioral and dietary changes. Long-term follow-up with doctors experienced in the care of patients having these procedures, as well as lifelong vitamin supplementation, is essential to avoid life-threatening complications.
**************************************************************************
4.6% is nowhere near the correct figures for ‘mortality rate’ in bariatric surgery. Mortality can be defined in many different ways, one year mortality (which is what L-B is parroting) usually has very little with the operation itself to do. This figure might come from an article by Flum et. al. that had looked at mortality in Medicare beneficiaries who, among other factors, had been operated by mostly low-volume centres.
There is ample evidence, easily found that Bariatric surgery decreases(!) all cause mortality.
I have to start a gastric bypass now so you will have to find this for yourself…
Chiropractic remarketing:
http://www.latimes.com/business/lazarus/la-fi-lazarus-chiropractors-diabetes-20160902-snap-story.html
Zero tolerance Björn to that type of crap!
Marketing Guru’s are one of my major hates!
@ Critical
You must be a big fan of the ads of plastic surgeons which subtly persuade people that their appearance is less than ideal; but I see no outrage about such capitalistic advertising when done by MD’s. Confirmation bias regarding marketing is alive and well among chiro haters. I don’t have the advertising statistics currently but I’d bet that plastic sugeons spend much more than Chiros for advertising.
More Tu Quoque.
Do you not have a cogent? argument?
Please comment with reasonable grammar, Frankster. English 101 should have taught you that “cogent” is an adjective, not a noun. BTW…no, I do not have a “cogent.” Did you bypass English in undergrad school to obtain an MD in six total years? That would explain your challenges with respect to grammar. Perhaps you would like to write an intelligible comment? Please advise, and please proffer something other than the drivel you’ve posted; you’ll appear less of a dolt.
@ Logos-Bios on Thursday 08 September 2016 at 00:58
If the best you have is an Ad Hominem over an obvious typo, there isn’t anything in the locker.
But you have tolerance for normal chiro crap?
When are you going to release you one of the vipers in the nest of vipers?
Describe to me exactly what “chiro crap” I use in my practice, Frankster. Also, what have I written in this discussion that supports your bogus contention that I have tolerance for said “chiro crap”? You assume too much for a person who views himself as an objective evaluator of facts. Your bias clouds whatever discerning capabilities you possess. I will await your hopefully cogent, on-point response.
@ Logos-Bios on Thursday 08 September 2016 at 18:24
“Describe to me exactly what “chiro crap” I use in my practice, Frankster. Also, what have I written in this discussion that supports your bogus contention that I have tolerance for said “chiro crap”? You assume too much for a person who views himself as an objective evaluator of facts. Your bias clouds whatever discerning capabilities you possess. I will await your hopefully cogent, on-point response.”
I was addressing Crackpot_Chiro, but I’m sure you realised that with your ever-so-superior intellect.
Nonetheless, I will answer your question; “chiro crap” is all of chiro. I don’t know how anyone can keep a straight face when describing chiro as anything other than a joke of 121 years standing. Invented by a convicted conman after he stole an idea from another crackpot, Still. The contrivance was solely for the purpose of duping money from the gullible, of which there are many.
The letter written by DD about the religion of chiropractic being his invention says it all. Palmer is in the same category as L. Ron Hubbard, Joseph Smith, Charles Taze Russell, and Mary Baker Eddy; religion for fun and profit, well actually, all about profit. He repackaged and renamed Still’s silliness and, bingo, a nice little earner, but you would know that, with your superior intellect and all. Chiro is premised on the supernatural and the ridiculous idea of energy flow in the nerves which, if restricted, causes disease. It is as much nonsense as Lord Xenu and thetans in Scientology.
In the 121 years since Palmer cured a deaf man by manipulating his neck (I always smile when I remember that story because the aural nerves do not go though the neck), chiro has broadened its base by, guess what, stealing modalities from others. Now it wants to assert itself as having “physician” status, as silly as that idea is. All you do is faff around with backs, doing nothing of any consequence.
Well LB, you lot aren’t even qualified to lance a boil.
Hilarious post by the Frankster, a man so proud to proffer his ignorant detritus about Chiropractice. How did he proceed? He discussed the profession circa its founding in 1895. What a scholar he is(not!). I wonder if the Frankentool would like me to further explore the history of medicine over the past 5/4 of a century. The story could be written in a number of ways, of course. I have shared a few of its quack-like failures which have cost thousands of perfectly healthy lives and deformed many others. Another poster requested examples of “negative spinning” regarding chiro; Frankentool’s prattle here is a fine example.
The story of medicine could also be written in a positive way, one which emphasizes its evolution and more researched, standardized diagnosis and treatment protocols. I actually prefer this positive descriptor because I respect the profession greatly. Truth can be told from both perspectives regarding medicine and chiro. Of course most of the pseudo-intellectuals on this site appear to self-gratify by criticizing chiro via typing with one hand and doing who knows what with the other(perhaps actually researching the subject? Of course not!).
@ Logos-Bios on Saturday 10 September 2016 at 01:25
You’ve written much; thrown insults, made suggestions of unknown character, and used Logical Fallacies but you have failed, as always, to address what I have written.
“The story of medicine could also be written in a positive way, one which emphasizes its evolution and more researched, standardized diagnosis and treatment protocols.”
Errr, that is the only way it can be written. Medicine addresses it errors and problems, and researches to advance itself.
“Truth can be told from both perspectives regarding medicine and chiro.”
No, it can’t, and the reason why not is stated by you in the first quote above. Chiro has not done research of any note and most points to low level evidence; it has not evolved to where it has cast aside its silly beginnings; it has no standardised diagnoses (the term and diagnosis subluxation is still being taught and used by many), and treatments vary from place to place, even to the extent of one chiro using an orbital sander as a treatment tool.
When there is evidence of efficacy, and all of the above problems have been dealt with, chiro will have a leg to stand on. Currently, and in the foreseeable future, all it has are feet of sand.
Of course, my expectation that you will actually address these matters is not very high (equal to nil) and is based on your childish behaviour and cognitive dissonance, as well as the trait you share with Crackpot_Chiro; the inability to process text. It would also be nice if you could understand the Fallacy Fallacy, of which you are particularly fond.
Cue the childish name calling…….
“You’ve written much; thrown insults, made suggestions of unknown character, and used Logical Fallacies but you have failed, as always, to address what I have written,” stated the Frankster. It’s quite ironical that he would state this about my posts when he has been quite guilty of same. Selective self-serving amnesia? I know, I know…..Frank will complain(again ironically) about tu quoque…so be it!
Chiropractic uses standardized diagnoses, at least where I practice. Educate yourself before you post contrarian and unsubstantiated pablum. Adhesive capsulitis is the same condtion whether diagnosed by a DC, MD, DO, or PT(if the law allows the PT to make a diagnosis), is it not? Venous insufficiency is the same condition no matter which doctor from whatever discipline diagnoses it, is it not? I really don’t know in what area of the world you practice but it should occur to you that practice characteristics might be different in one country/continent than another.
Orbital sander as a treatment tool? This sounds absurd. For what condition was the device being utilized? Would you be so kind as to provide a link? Be advised that such practices are not taught in accredited US schools of which I’m aware. As a side note, a medical quack in my area was finally stripped of his license for continuing to prescribe Laetrile for breast CA. Furthermore, there are still “modern medicine” clinics/centers which prescribe it for various malignancies. By your standards I would be expected to paint you with the same quackery brush as I would them; but I won’t. You’re likely not a quack, but you are a reductionist when it comes to chiropractice. You induce your opinions from what purportedly you have observed of Chiropractic in your area of the world. News flash! What you have described about chiropractic ad nauseum in your multitude of rants over the last few days does not in any way describe my practice.
…and you have given us ample of evidence of your rational approach?
@Frank Collins
You truely are deeply entrenched and incapable of change!
You are as much a part of the problem as the worst subluxationist!
So what is the “basic premise” that all chiropractors including myself subscribe to?
You could learn from Bjorn Geir and the recent exchange on pseudo-critics! He got what I was talking about, had a laugh and then gave a decent, well written and considered reply! You on the other hand just cheched to see who were the owners of the site that I linked and went after them! Shooting the messenger and not debating the topic!
“You left out the most important part, something which the prof has been saying for years; there is no evidence to support chiropractic as a healthcare profession.”
“no evidence” Frank! In regards to chronic musculoskeletal conditions its low to moderate!
In regards to subluxation it is zero and we agree on that point!
Now its about time you made the distinction or you are just carpet bombing with generalizations!
“Using Tu Quoque, as you do often, does not diminish its lack of evidence.”
Low to moderate evidence is similar or better to other approaches for spinal pain and in the current health care environment where cost benefit and risk benefit are huge this is very relevant where you compare likes! Should there be more research and better evidence? Absolutely but you are very blinkered in your criticism!
You could also learn Prof Ernst! I have emailed him in regards to research and he gave me a courteous detailed reply. Quite a while ago Prof Ernst commented about the lack of blinding in regards to chiropractic research. I cited two studies (one by Howard Vernon) and he replied that they looked promising! He was prepared to look at what I presented and evaluate it at face value! You on the other hand just ignore or dismiss if it does not agree with your view!
“It isn’t the first time I have used this name for you so your indignation now is hard to fathom.”
So if you continue to use the term and repeat yourself then that makes it acceptable?
@ Critical_Chiro on Monday 05 September 2016 at 05:07
“You truely are deeply entrenched and incapable of change!
You are as much a part of the problem as the worst subluxationist!”
The word is “truly”. There is a reason for the red underlining.
Another Tu Quoque; https://en.wikipedia.org/wiki/Tu_quoque
(For krist’s(sic) sake, read it so you won’t look more like a fool.)
“So what is the “basic premise” that all chiropractors including myself subscribe to?”
That isn’t what I wrote (yet another sign of your dissonance), this is; “apart from portraying chiro as pseudo-scientific nonsense unable to define its basic premise”. What I thought I made clear (it seems to everyone but you) is that kyro(sic) is unable to define what it is and what it does, that is, its basic premise. I hope you are embarrassed because I’m feeling embarrassed at the need to explain something so self-evident in such a simplistic way.
“You could learn from Bjorn Geir and the recent exchange on pseudo-critics!”
I do; that is the difference. You only absorb from Björn that which is not dissonant.
” He got what I was talking about, had a laugh and then gave a decent, well written and considered reply! You on the other hand just cheched to see who were the owners of the site that I linked and went after them! Shooting the messenger and not debating the topic!”
Björn is a very decent human being, from all appearances, and is more tolerant of your nonsense than I think he should be. I did check the owner of the site for a good reason; whether there was a Trojan Horse (look that up too). The owner/s are quacks, just like someone else here.
“In regards to chronic musculoskeletal conditions its (sic) low to moderate!
In regards to subluxation it is zero and we agree on that point!
Now its about time you made the distinction or you are just carpet bombing with generalizations (you are Australian, the word is spelled with an “s”)!”
Finally, some small admission of the worth of kiro; low to moderate, however, you still practice the nonsense. Do doctors (real, not you) practice with science that has low to moderate evidence of everything? Cognitive dissonance is your hallmark.
““Using Tu Quoque, as you do often, does not diminish its lack of evidence.”
Low to moderate evidence is similar or better to other approaches for spinal pain and in the current health care environment where cost benefit and risk benefit are huge this is very relevant where you compare likes! Should there be more research and better evidence? Absolutely but you are very blinkered in your criticism!”
More Tu Quoque: you really should read what it means and it may stop you writing such drivel. We are discussing chyro, not anything else. You claim to be the go-to person for doctors with difficult patients but you never stop to think why. All you are doing is making money from saps because of regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect.
“You could also learn Prof Ernst!”
Why are you insulting the prof.?
“I have emailed him in regards to research and he gave me a courteous detailed reply. Quite a while ago Prof Ernst commented about the lack of blinding in regards to chiropractic research. I cited two studies (one by Howard Vernon) and he replied that they looked promising! He was prepared to look at what I presented and evaluate it at face value! You on the other hand just ignore or dismiss if it does not agree with your view!”
OK, where are they? What does the prof have to say about them?
““It isn’t the first time I have used this name for you so your indignation now is hard to fathom.”
So if you continue to use the term and repeat yourself then that makes it acceptable?”
No, it just means that you have great difficulties processing text, as evidenced here many times.
Carefully read what Pete Atkins wrote on Sunday 04 September 2016 at 18:35. He has you framed perfectly.
Dear Frankentool, Your recent comments regarding the lack of universal healthcare in America as being one of affordability was a hoot, a further evincing of your proclivity to comment on matters in which you are pathetically ignorant. You really should comment on things you understand at least nominally lest you expose yourself as a dolt; admittedly, you have much experience with being “dolt-like.”
Earth to Frnakentool: America’s decision to not embrace universal healthcare was not a matter of affordability. I look forward to hopefully more cogent comments from you on this matter. Perhaps we might engage without personal attacks for a change? Happy Googling!
@ Logos-Bios on Sunday 11 September 2016 at 14:39
“Dear Frankentool, Your recent comments regarding the lack of universal healthcare in America as being one of affordability”
I didn’t write “affordability”; I wrote “afford” in the context of definitions 1, 4, 5, and 6. I am fully aware, and expected others to also appreciate, the the US has the money to be able to do it.
http://www.dictionary.com/browse/afford
verb (used with object)
1.
to be able to do, manage, or bear without serious consequence or adverse effect:
The country can’t afford another drought.
2.
to be able to meet the expense of; have or be able to spare the price of:
Can we afford a trip to Europe this year? The city can easily afford to repair the street.
3.
to be able to give or spare:
He can’t afford the loss of a day.
4.
to furnish; supply:
The transaction afforded him a good profit.
5.
to be capable of yielding or providing:
The records afford no explanation.
6.
to give or confer upon:
to afford great pleasure to someone.
Are those glass walls not shattered into oblivion?
America does have the money to afford universal healthcare but the majority of its citizens don’t want it because of myriad reasons, many of which are political. Simply because something is “affordable” doesn’t necessarily mean it should be pursued. America is a democratic republic and many don’t ascribe to collectivist, redistributionist entitlements; ergo, such a program has not been successfully enacted.
As you might recall, America has participated in treaties binding it to militarily defend approximately 25% of the world’s population. The Land of Opportunity affords citizens(and, often, non-citizens) the opportunity to individually succeed. It’s general mentality has historically been based on individual freedoms to succeed, build financial security, and to gift one’s assets to his heirs. Classical Americanism does not advocate for government dependency. Universal healthcare would be quite expensive and would require the top 10% of its fed taxpayers to contibute more than the 70% they personally are currently taxed. There’s simply not the political will to provide universal healthcare with the many other financial committments the US has.
@Frank Collins
Thanks for being nitpicky over those typo’s Frank! Both doctors I work with who are reading this blog now owe me a coffee!
“We are discussing chyro, not anything else. You claim to be the go-to person for doctors with difficult patients but you never stop to think why. All you are doing is making money from saps because of regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect.”
Constantly assessing what I do and ask Why Frank! I also discuss what is pain, regression to the mean, self limiting etc with patients and transition them to active self care and management as quickly as possible!
Why do the doctors refer to me? I frequently ask that question as 80% of my new patients are by referral and you may be surprised to know that I sit down with my (sap) referring doctors and asked them as well! You make assumptions on how I practice! Also you fail to realize the degree of accountability that is implicit with the medical referral!
As I said before you are part of the problem Frank just like the subbies and incapable of change!
@ Critical_Chiro on Monday 12 September 2016 at 08:20
“Thanks for being nitpicky over those typo’s Frank!”
It wasn’t because of a typo that I pointed it out. It was because you see red flags and ignore them, just as you do with kyro.
“Both doctors I work with who are reading this blog now owe me a coffee!”
Are the doctors who are prepared to ignore the lack of evidence or is their opinion worth more than all of the (lack) of evidence in Cochrane? Either way, they betray science and medicine. Sure, they may have a good laugh at this, but who is the laugh on?
“Constantly assessing what I do and ask Why Frank!”
For the simple reason you ignore evidence for your own financial favour, while still claiming you have a “profession” worth persisting with. How far can you push your head into the sand?
“I also discuss what is pain, regression to the mean, self limiting etc with patients and transition them to active self care and management as quickly as possible!”
Big deal. They could go to a physio with a real qualification.
“Why do the doctors refer to me? I frequently ask that question as 80% of my new patients are by referral and you may be surprised to know that I sit down with my (sap) referring doctors and asked them as well! You make assumptions on how I practice! Also you fail to realize the degree of accountability that is implicit with the medical referral!”
Accountability for what? Regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect are responsible for most of what you achieve, so where is the accountability?
“As I said before you are part of the problem Frank just like the subbies and incapable of change!”
Tu Quoque and False Equivalency. Get a real job.
Friday lunchtime! Time for some enjoyable discussions on this site!
@FC
“Tu Quoque and False Equivalency.”
Subbies stubbornly fight reform and you dismiss reform and look on it as acceptable collateral damage when making sweeping statements! You are both part of the problem for different reasons!
Now you shoot the doctors!
“Accountability for what? Regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect are responsible for most of what you achieve, so where is the accountability?”
Patients that have chronic LBP for 8 or more months and have been unresponsive to usual care? That is the type of patient that I initially get referred by doctors! Are they just happy to offload that frustrating patient? At the beginning of the referral relationship probably yes! But as time goes on they start to use me as a first line treatment option! I work with doctors and I am just another tool at their disposal! (I’m sure you will have some fun with that word!). I discuss regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect with my doctors and patients and most importantly when it comes to discussing the possibility of any future flare-ups! I would rather the patient understand pain and self manage than constantly come back and treat me like a panel beater!
There is a very interesting dynamic when it comes to medical referrals. If I do a good job the patient is happy with the referring doctor not me! If I stuff-up the patient is annoyed with the doctor not me! Doctors do not refer lightly be it physio, ortho, neuro or chiro as it reflects straight back on them! Being included on a doctors referral network is a big deal!
You underestimate the level of accountability Frank!
@ Crackpot_Chiro on Friday 16 September 2016 at 04:10
I will now use this title because it is apt.
“Friday lunchtime! Time for some enjoyable discussions on this site!”
I’m not surprised. After a week of dispensing bullshit, anyone would need some respite.
“Subbies stubbornly fight reform and you dismiss reform and look on it as acceptable collateral damage when making sweeping statements! You are both part of the problem for different reasons!”
When will you learn how to process text? The question has been asked many times; REFORM WHAT? Cognitive dissonance will prevail and the usual crap will come from you.
“Now you shoot the doctors!”
Do you know any other language other than hyperbolic bullshit?
**********************************************************************
“Accountability for what? Regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect are responsible for most of what you achieve, so where is the accountability?”
Patients that have chronic LBP for 8 or more months and have been unresponsive to usual care? That is the type of patient that I initially get referred by doctors! Are they just happy to offload that frustrating patient? At the beginning of the referral relationship probably yes! But as time goes on they start to use me as a first line treatment option! I work with doctors and I am just another tool at their disposal! (I’m sure you will have some fun with that word!). I discuss regression to the mean, self-limiting conditions, natural progression of healing, and the placebo effect with my doctors and patients and most importantly when it comes to discussing the possibility of any future flare-ups! I would rather the patient understand pain and self manage than constantly come back and treat me like a panel beater!
There is a very interesting dynamic when it comes to medical referrals. If I do a good job the patient is happy with the referring doctor not me! If I stuff-up the patient is annoyed with the doctor not me! Doctors do not refer lightly be it physio, ortho, neuro or chiro as it reflects straight back on them! Being included on a doctors referral network is a big deal!
**********************************************************************
Did they not teach you paragraphing at chiro school? And, yes you are right, only because you provide the evidence.
“You underestimate the level of accountability Frank!”
No, I underestimate the level of laziness to which doctors will sink to make life easier for themselves and devolve responsibility for a low level condition to a quack. It worries me that doctors (not you) are happy to ignore the evidence of Cochrane but accept it to treat serious conditions. You may be be very personable, however, you are still a quack clinging to bullshit.
@Frank Collins
“REFORM WHAT”
And that nicely summarizes your refusal to acknowledge reform! Your mired back in 1910 with the subluxationists!
“devolve responsibility for a low level condition to a quack”
Are you aware of the burden of back pain on the health care system and its prevalence?
“Did they not teach you paragraphing at chiro school?”
You can be very petty at times Frank!
@ Crackpot_Chiro on Saturday 17 September 2016 at 02:05
“@Frank Collins
“REFORM WHAT”
And that nicely summarizes your refusal to acknowledge reform! Your mired back in 1910 with the subluxationists!”
What it does illustrate is your refusal to acknowledge the dearth of evidence for chiro, as well as your persistent use of Tu Quoque. It makes you worse than subluxationists; at least they persist with their nonsense out of wilful ignorance and stupidity. You claim to be a great reformer and the question stands; OF WHAT?
“Are you aware of the burden of back pain on the health care system and its prevalence?”
Strangely enough, yes. Using a Red Herring and an unproven methodology won’t change that.
““Did they not teach you paragraphing at chiro school?”
You can be very petty at times Frank!”
Then write correctly and there won’t be any reason to complain. I am intrigued you point to me having a problem when you caused the issue. Not that pointing out errors has ever succeeding in changing your thinking.
Logos-Bios on Tuesday 06 September 2016 at 18:10 wrote: “I think you [Prof Ernst] should educate yourself regarding the goal of any type of physical rehabilitaion, whether performed by a chiro physician, PT, or both. The goal is not simply relief of symptoms; rather, goals involve progressive increase in function.”
@ Logos-Bios
If you had taken time to read Professor Ernst’s bio at the top of this page, you would have learnt that he is a former Professor in Physical Medicine and Rehabilitation (PMR) at Hannover Medical School, Germany, and the former Head of the PMR Department at the University of Vienna, Austria:
http://edzardernst.com/about/edzard-ernst/
LB is hilarious, isn’t he?
My quoted comment stands, Blue. Do you disagree with it? If so, why?
Regarding Edzard, I couldn’t care less if he is the world’s greatest physican, a former PM&R, or a massotherapist. This is a forum for dialogue, isn’t it? Besides, I don’t think he would disagree with the comment of mine which you quoted in the post to which I’m responding.
Logos-Bios wrote: “My quoted comment stands, Blue [“I think you [Prof Ernst] should educate yourself regarding the goal of any type of physical rehabilitation, whether performed by a chiro physician, PT, or both. The goal is not simply relief of symptoms; rather, goals involve progressive increase in function.”] Do you disagree with it? If so, why?”
Clearly, given his background, Professor Ernst does not require to ‘educate’ himself regarding the goal of any type of physical rehabilitation.
Logos-Bios wrote: “Regarding Edzard, I couldn’t care less if he is the world’s greatest physican, a former PM&R…”
I would suggest that you do start caring about his academic prowess, not least because your defence of your arguments in this dialogue is less than impressive. For example, it would seem that you are unaware that chiropractic cannot be recommended as an intervention due to its lack of standardisation. IOW, it currently carries an unfavourable risk/benefit profile:
Quote
“Chiropractors view the spine as an entity. Where they diagnose ‘subluxations’, they will normally manipulate and ‘adjust’ them (11). And ‘subluxations’ will be diagnosed in the upper spine, even if the patient suffers from back pain. Thus many, if not most back pain patients receive upper spinal manipulations. It follows that the risks of this treatment should be included in any adequate risk assessment.”
Ref: Spinal manipulation for the early management of persistent non-specific low back pain — a critique of the recent NICE guidelines, Edzard Ernst, Int J Clin Pract (18th August 2009). Reference (11) is Ernst E. Chiropractic: a critical evaluation. J Pain Sympt Man 2008; 35: 544–62. Page 6 of the paper mentions a report that indicates that only 11% of all cervical manipulations are “appropriate” and gives the reference Coulter I, Hurwitz E, Adams A, et al. The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, CA: RAND, 1996:18e43.
Furthermore (and returning to the title of this blog post), one well-known chiropractic marketing guru/leader posted the following video three days ago in which he admitted that chiropractic was ‘dying’ and hoped he could convince his viewers that he knew what to do about it…
QUOTE
“Chiropractors are struggling – this is what most people are not willing to talk about. It’s time to have an honest conversation in our profession and start doing things that will turn it around. It is frustrating to watch chiropractors hoping and praying for things to be better or be different. The truth is it’s not going to get better if you just sit there and pray. It is not about being negative or positive – it is highlighting the painful truth. Most chiropractors are practising and NOT ADAPTING to the market accordingly. As a collective, if chiropractors don’t adjust (pun intended)- we will only fall further and further behind. And for each month or year, we fall behind; it will be that much harder to close the GAP. We expect our patients to understand the concept of the importance of the nervous system, and an “adjustment” will allow the body to adapt better to its environment. In the same breath, most chiropractors don’t go and get an “adjustment” to their practice. How on earth are we going to ADAPT to our market? Recently, I presented to a group of chiropractors in Queensland via Skype. Here is a LIVE recording of this presentation. It’s about 18 mins long… but it will be worth it.”
Link: https://www.youtube.com/watch?v=Wq6uF8Su9sk
Very telling.
Very telling indeed……I wonder why you didn’t quote the ACA position on the state of the chiropractic profession?
I didn’t diss Edzard in any way. Why did you state otherwise? My comment was to Blue Wode and it clearly noted that it was viable irrespective of Edzard’s admirable credentials. BTW, Neither Edzard nor anyone else refuted it. You should read before you type so that you are less incoherent. You’re welcome!
Don Rickles(er, Edzard) quipped that I am beyond being enlightened. LMAO
I wonder if the charlatan telling big tales of miracle cures in this video has some relation to our present mystery guest Logos-Bios?
https://www.youtube.com/watch?v=O2N860A6_iE
I specially love the words at about 2:00 about it not matter if what they do is medically correct… 😀
very likely
“I specially love the words at about 2:00 about it not matter if what they do is medically correct… ” The continuation is “Who heals is right.” Words fail me!
Why would you think this, Dr. Geir? You have no evidence to support such a query, do you?
I simply LOVE the smartphone app promoted by bariatric surgeons in their quest for new patients. The app is a take on those used by automobile manufacturers which allow prospective purchasers to self-design their cars with options and color combinations. The surgeons’ marketing campaign evinces morbidly obese people being able to “swipe away” their bulges and ultimately arrive at a normal weight. The video is enticing….exactly what such surgeons desire in their quest for more self-pay patients who are uncomfortable(yet mostly healthy) in their own skin. Pot……meet kettle.
Well, at least the “Logos-Bios”-loudmouth does not deny being one and the same as that comic nail-removing narcissistic clown in the video 😀 .
Seems to get most of his ideas about the world of medicine from ads in the yellow press and cannot even put together a decent straw man from it – what a pitiful adversary 😛
And BTW, the name is not ‘Dr. Geir’ 😉
Geir again deflects from the blatant appeal to profit as evinced by unscrupulous surgeons who advertise miraculous physical metamorphoses of some of the world’s most psychologically vulnerable citizens. Tsk, tsk. Yet here is Geir, unable to defend the trolling by his brethren, retreating to his typical modus operandi of insulting the messenger. He must be a liberal, and a dull-minded one at that.
@Logos-Bios
You really should not be expressing yourself publicly while intellectually incapacitated, be it from alcohol or other psychoactive chemicals or just simple, belligerent stupidity?
Your ramblings are largely incoherent, childishly unintelligent and irrelevant to the topic of this post. It seems to be impossible to carry a discussion with you as you blindly continue writing unsubstantiated nonsense and parroting cherry picked irrelevances even if contradicting facts are laid out for you, with references. Your vacuous, distasteful contributions are giving chiropractic and chiropractors an even worse reputation than most of them deserve.
Again Geir produces a personal attack. The man who introduced “breast fondling” into the discussion must indeed be expert in who should “express himself/herself publicly.” Considering his apparent infatuation with carnal non sequiturs, it’s not surprising that he would refer to “cherry-picked irrelevancies.” Geir offers little of substance in his comments, but his predilection for tu quoque and disgusting prose is on full display. Priceless!
Given the following random quotes from Logos-Bios…
• stated Mr. Rawlins in his baseless rant
• The Frankster really needs to elevate his communication skills to a more professional level to be taken seriously
• “Big Al” could conjure nothing substantive to counter my post to which he replied
• You just have to love Edzard’s one-liners, simple-minded as they are.
I am beginning to suspect that he is from the SkepdicProf School of Trolling:
http://edzardernst.com/2014/01/chiropractors-use-of-x-rays/#comment-55244
he is comedy gold – at least for a while and in small doses.
“Comedy gold,” states Edzard. Without realizing it, he captured my own take on the majority of the (non-)insightful comments I have read here as authored by the usual suspects. While I do look forward to some serious conversation(hopefully sooner rather than later), I do find it amusing(at least time-consuming) to read the concerted anti-chiro comments from socialist drones.
If indeed the L-B is skepdic-prof reincarnated, then its intellectual impairment must have deteriorated. The skepdic, if I recall correctly, was just an ordinary troll and could at least maintain a somewhat coherent dialog and wasn’t quite as illogical and unpleasant.
@ Logos-Bios on Saturday 10 September 2016 at 22:13
““Comedy gold,” states Edzard. Without realizing it, he captured my own take on the majority of the (non-)insightful comments I have read here as authored by the usual suspects. While I do look forward to some serious conversation(hopefully sooner rather than later), I do find it amusing(at least time-consuming) to read the concerted anti-chiro comments from socialist drones.”
It is interesting how one word can, sometimes, clear up some vague impressions to give a direct view of a person and their views. That word is “socialist” and, while it is obvious you are a Septic, it shows your beliefs, as hideous as they are.
The Right, particularly the Religious Right (aka the American Taliban), is the major reason why the US can be both the best and worse place in the world, and why I will never go there. To be labelled “socialist” by the a member of the Right is a telling pejorative used by the worst hypocrites and self-righteous loons this planet has.
Being a member of the Right gives you special privileges; the ability to dupe, control and exploit those who know no better. The gullible, the intellectually less abled, the vulnerable, the weak, the emotionally fraught, the easily lead; all are fair targets for those in the “Land of Opportunity” to use as stepping stones for their own monetary advantage. The richest country in the world but it does not afford universal healthcare or provide adequately for those who cannot care for themselves.
Unless I can be proved wrong LB, I regard you as detestable scum; sadly, a prime candidate to be a chiropractor.
Interesting comments regarding the religious right and American Taliban by Frankentool, a dullard who was unable to discern my implication that the practice of healthcare is a bit different in capitalist nations wherein physicans must deal with market pressures relative to not only clinical outcomes and for-profit managed care pressures, but also to great financial stressors indigenous to ever-changing diagnosis-reporting/coding and documentation mandates…at their own expense. I’ll try to simplify things for you, Tool: I wasn’t denigrating you for possibly living in a socialist country. Rather, I was subtly(too subtle for you, apparently) introducing you to the reality that chiropractic(and medicine, for that matter) might well be practiced quite differently in my neck of the woods than in yours. I bet such a notion never crossed your prodigious mind, did it?
Frankentool’s diss to me as “detestable scum” will be worn as a badge of honor since any person of science(or bigoted interpretations of same ala Frankentool) who has been so consistently wrongheaded in his posts regarding chiropractice is assuredly erroneous in his conclusions about me. Frankly, Tool, you have literally demonstrated zero chops regarding just about anything you have posted regarding the chiropractic profession. Furthermore, you obviously prefer to hurl insults and sarcasm into virtually every conversation regarding the subject instead of attempting to engage for the purpose of learning. You are more of a cynic than a scientist.
please keep going, you are hilarious!
@ Geir
Skepdic-prof? What does this even mean? Are you communicating in code to your “cherrypicked” anti-chiro buds on this site?
You mentioned that I am unpleasant; such is hardly the case. However, since I decided to share a few thoughts on this site I have been met with consistent unpleasantness from you and just about everyone else; I merely respond in kind. I would in the future appreciate more educated, less vitriolic, conversations about healthcare issues. How about you? Please advise.
Edzard,
Both Logos-Bios and Iqbal Krishna are currently providing gold-standard comedy that I shall incorporate into my Pink Unicorn Therapy, which (many thanks to them, “jm”, Tom Kennedy, and a few other commentators on your website) is becoming increasingly backed by the solid evidence provided by these highly-vocal experts in 21st Century alternatives-to-medicine.
If not Doctor Geir, perhaps Doctoid Geir would be more appropriate? Please advise.
Some chiropractors see the future in toddlers and children:
https://youtu.be/F7g93V6tw_g
People who have understood that going back to old, natural ways is the only option to live healthy are on a rise; therefore chiropractic does seem to have a decent future.
going back to old natural ways, like dying around the age of 30, you mean?
Modern science cannot guarantee you cannot die before 30 or after that. The point I am raising is, we are surrounded by too much devices, gadgets and technology, even vegetables and fruit we eat today are mostly not 100% natural. Humanity is suffering due to this, turning back to ways that nature has introduced to us is the right way, now you can take whatever definition of nature or natural you want, but I have seen people healthier near to nature.
this is fairly meaningless waffle
“I have seen people healthier far from nature” would make just as much sense.
I don’t doubt that, as it is quite possible. My question to you would be: how many of these people make it past 50 and how many who live far from nature make it past 50, in absolute and relative terms?
@ Empirical Point Acupuncture on Saturday 17 September 2016 at 08:47
“Modern science cannot guarantee you cannot die before 30 or after that.”
No, but it does give you a far greater chance than 100 years ago.
“The point I am raising is, we are surrounded by too much devices, gadgets and technology,”
Then stop using the technology to access this blog, advertise on the web, travel to your witchcraft centre, and using your mobile phone. That should help you individually.
“even vegetables and fruit we eat today are mostly not 100% natural.”
They haven’t been “natural’ for hundreds of years, in some cases thousands, of years. They have been selectively bred to improve all aspects for human consumption.
“Humanity is suffering due to this, turning back to ways that nature has introduced to us is the right way, now you can take whatever definition of nature or natural you want, but I have seen people healthier near to nature.”
You make a habit of making ridiculous statements. A 100 years ago, life expectancy was half of what it is today.
LOL! That is funny.
@ Empirical Point Acupuncture on Friday 16 September 2016 at 12:54
“People who have understood that going back to old, natural ways is the only option to live healthy are on a rise; therefore chiropractic does seem to have a decent future.”
Apparently, Sharon (the proprietor of Empirical Point Acupuncture) can displace modern medicine for all sorts of conditions (https://www.philadelphia-acupuncture.com/conditions-treated/);
Empirical Point Acupuncture provides supportive therapy and restoration of balance for the following conditions:
Allergies (especially those localized / prevalent in the Philadelphia area)
Constipation and diarrhea, indigestion, gastritis, IBS
Stress incontinence and urinary tract infections
Irregular, heavy or painful menstruation, infertility in women and men, premenstrual syndrome (PMS), symptoms of menopause and sexual dysfunction
Nausea, pain and other side effects of cancer therapies
Arthritis, neuralgia, nerve disorders
Hypertension, angina pectoris, arteriosclerosis, poor circulation and anemia
Emphysema, sinusitis, asthma, allergies and bronchitis
Eye, ear, nose and throat issues, cold and flu
Eczema, psoriasis, acne
Depression, anxiety, insomnia
Seasonal Affective Disorder
General tune-up, immune support
She can even diagnose by taking a pulse (https://www.philadelphia-acupuncture.com/pulse-diagnosis/);
“Pulse Diagnosis
Pulse Diagnosis is a touch-based method of reading a person’s health by assessing the qualities of the radial pulse. Drawing largely from ancient methods of identifying and interpreting the pulse, it allows a practitioner to gather diagnostic information by feeling the pulse at principle and complementary positions on both wrists.”
There is an explanation and history of acupuncture too (https://www.philadelphia-acupuncture.com/defining-acupuncture/), but she leacves out the part about Mao reviving it for expediency.
As we have seen many times before, these fruitloops pop up and make some ridiculous claim/s.
@Tim, the enchanter: let me quote a famous Chiropractor, Jim Morrison: “you can’t petition the lord with prayer”.
So do you actually believe YOU can “treat away” the “source”, “cause” or “underlying reason” of your clients PAIN? You and your 20+ entrepreneurial-theatrics?? As opposed to transient, unimpressive and insubstantial “pain relief” equivalent to an aspirin, a tube of Ben Gay or simply ‘staying active’?
What profound insights must you possess in order to adjudicate WHICH of the theatrics to bestow?
Do you follow with exacting precision the precepts laid out by the founding-guru?….leg-checks, motion-palpation, muscle-challenges….thermography!! Or just make it up as per the gullibility quotient of the victim lying before you?
How in gods name could all that bullshit do anything but serve YOUR game-plan…i.e. financial remuneration?
It seems your exhaustive litany-of-trickery is simply to assure you don’t lose a potential victim to one of the other frauds in your neighborhood….whose “techniques, skill and procedures” I’m sure you roundly criticize as you self-aggrandize to anyone who will listen.
I’d say it’s your ilk well studied in psychology….